Man, 57, noticed growth on the side of his tongue ‘one month’ before dying of bowel cancer
The case study marks a unique instance where bowel cancer cells have broken away from an original tumour and travelled to the oral cavity.
Part of what makes cancer so deadly is its unmatched capacity for invading different tissue. The longer a tumour is untreated, the greater opportunity it has to metastasise to neighbouring organs. Very rarely, however, do tumours in the bowel spread to the mouth.
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Some research states that the tumours which are most likely to spread to the oral cavity are those that start in the pancreas.
When colorectal cancer cells break away from the original tumour and enter the bloodstream, they often end up in the liver, lungs and brain.
Researchers, however, have previously highlighted rare instances where soft tissue of the mouth has been invaded by bowel cancer cells.
One such case was flagged by the Journal of Case Reports in Otolaryngology in 2015 in the hope of inspiring new treatment approaches to metastatic cancer.
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The researchers noted: “We present a case of a 57-year-old male with a history of stage IV rectal adenocarcinoma metastatic to the lung who presented to our clinic with a painful mass on the right lateral noticed one month before."
The patient had been diagnosed with bowel cancer two years prior after doctors found a polyp in his colon during a colonoscopy.
There was no evidence of metastasis at this time, so the patient proceeded with treatment from radiotherapy and chemotherapy.
Eight months later, however, tests revealed cancer cells had spread to the patient’s left lower lung, which warranted surgery.
Another seven months later the patient presented to his clinic with a painful mass on the right side of his tongue.
There was no evidence of weight loss or fatigue - common cancer symptoms - and the patient said he was a non-smoker.
“Unfortunately, the patient was unable to complete his chemoradiation theory and passed away with disease despite all efforts,” explained the researchers.
How long does it take for cancer to metastasise?
When a polyp forms in the colon, chances are it will exist for 10 or so years before developing into malignancy.
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The more the cancer cells spread the poorer the prognosis, with metastasis accounting for approximately 90 percent of cancer deaths.
While bowel cancer metastasis to the oral cavity is rare, it is even rarer to see these cancers metastasise to the oral soft tissue.
“Diagnosis of an oral metastatic lesion typically confers a dismal prognosis, despite treatment with surgery or chemo-radiation therapy, and has a median survival of six to eight months,” warned the case study authors.
The researchers encourage doctors faced with a tumour of the oral cavity to maintain a high index of suspicion for a possible metastatic source.
What are the early signs of colon cancer?
Fortunately, most people with early-stage colon cancer do not see symptoms, but their tumours may still be accidentally discovered during a screening test or colonoscopy.
Persistent changes in bowel habits, like diarrhoea and constipation, are among the first bodily changes to raise suspicion.
Often patients notice rectal bleeding after passing stool or experience a feeling that the bowel hasn’t emptied completely.
The National Cancer Institute recommends that people see a healthcare provider if these symptoms last longer than two weeks.
